People talk a great deal about visible wounds. But far less is said about those carried within. According to the World Health Organisation, 72 per cent of Ukrainians have experienced mental health issues over the past year, most commonly anxiety and depression, yet only one in five seeks professional help. During his visit in June, David Miliband, Chair of the International Rescue Committee, described the impact of the war on mental health as one of its least discussed consequences. This issue rarely features in the news, even though it affects millions of families.
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A scale that is difficult to grasp
Data from the Ministry of Health’s Centre for Public Health show a steady increase in the number of consultations. In 2024, more than 740,000 patients received medical care for mental and behavioural disorders. Of these, 542,000 consulted their GP with such complaints — almost four times as many as the previous year — and this increase reflects the shift towards bringing care closer to the patient. Among the disorders most commonly reported, organic conditions such as dementia, the effects of psychoactive substance use, and neurotic disorders — phobias, anxiety and panic attacks, and post-traumatic stress disorder — predominate.
In 2025, more than 260,000 Ukrainians received primary mental health care, 17 per cent of whom were children. A needs assessment of the population, carried out as part of a nationwide programme, showed that between 40 and 50 per cent of citizens will require psychological support of varying degrees of intensity. According to estimates by the WHO Country Office in Ukraine, 68 per cent of people report that their health has deteriorated compared to the pre-war period, and mental health is inseparable from physical health.
Why do people keep quiet?
The gap between the number of people experiencing difficulties and those who actually seek help is due to several reasons. Stigma leads people to view seeking help from a psychologist as a sign of weakness, although among those who did seek help, almost 92 per cent were satisfied with the support they received. Access to services depends on the security situation and the distance to the nearest facility. According to WHO estimates, in December 2025, 59 per cent of residents in frontline areas rated their own health as poor or very poor, compared with 47 per cent in more remote regions, whilst access to care remains more limited for displaced people and those living near the front line. A delayed visit results in a condition that could have been halted at an early stage becoming more severe.
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What is actually backed by evidence
The Ministry of Health’s clinical guidelines, developed in accordance with international standards, clearly define the first-line treatments for adults with post-traumatic stress disorder. These are trauma-focused cognitive behavioural therapy and eye movement desensitisation and reprocessing, known by the acronym EMDR. For trauma associated with armed conflict, torture, political imprisonment or forced displacement, the guidelines recommend narrative exposure therapy. Where trauma-focused approaches are not available, present-focused therapy or stress resilience training is used.
Medication plays a supporting role in this framework. The Ministry of Health’s guidelines caution against considering pharmacotherapy as a routine first-line treatment in place of trauma-focused psychotherapy. Where necessary, selective serotonin reuptake inhibitors — such as sertraline, paroxetine or fluoxetine — are prescribed. The key principle of the evidence-based approach is that trauma-focused work in the therapist’s office remains the foundation, whilst medication enhances this in more complex cases.
Where to go for help
The system is deliberately designed to bring specialist support closer to the individual. Psychological counselling is available right from the primary care level — from a family doctor, general practitioner or paediatrician who has undergone special training. Over 83,000 healthcare professionals have completed the WHO’s global mhGAP programme, which trains primary care doctors to recognise symptoms, provide basic care and, where necessary, refer patients to a specialist. At the same time, a network of Mental Health Centres is being developed, with around 90 facilities currently operational, alongside mobile multidisciplinary teams working within communities. Online resources and care pathways are available on the ‘How Are You?’ platform, created on the initiative of Olena Zelenska.
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A funding bottleneck
The development of these services depends on funding, which is dwindling. Psychosocial support is one of the areas that is among the first to be cut when humanitarian budgets are reduced. The ‘How Are You?’ platform was originally set up with the support of the US Agency for International Development, and the withdrawal of US funding has left projects dependent on it vulnerable. People who have survived war-related violence need not a one-off consultation but long-term support, and it is precisely the continuity of services that is most difficult to guarantee under conditions of short-term donor commitments.
A separate story about the children
Children’s minds react to war in their own way. Among the most common reasons why children are referred to specialists are difficulties with attention and concentration, anxiety and sleep disorders, with schooling itself becoming a specific trigger. The fact that almost one in six of a psychologist’s patients is a child shows just how deeply the experiences of recent years have affected a generation growing up to the sound of air-raid sirens. Working with children requires the involvement of the family, and guidelines recommend family-based interventions rather than simply supportive counselling in the first few months following a traumatic event.
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